INTERNATIONAL STUDENT FINANCIAL AID APPLICATION

Instructions: This form should be completed and returned with the required documentation to:
Coe College, Office of Admission, 1220 First Avenue NE, Cedar Rapids, IA 52402 USA
Deadlines: Fall Term: March 1 Spring Term: October 1

General Information: The United States Department of Homeland Security requires documentation of financial support from
each student before an I-20 may be issued. This application will also be used to determine any available need-based financial aid.

Name Female
Male
Family (Surname) Given (First) Middle
Address Date of Birth

Month / Day / Year

Email

Country of Birth: Country of Nationality:

Expected Date to begin studies: Exchange Rate:

(your country rate / US Dollar)

Family Information: Please provide the below information for all members in your family that depend of the income of your parents
for daily living expenses.

Expected Annual Parent’s

Name Age Relationship to you Year in
date of School contribution
school
graduation fees

Financial Information: During the last year, which sources provided your household income?

Father’s Work $ Family Business $ Other (explain): $

Mother’s Work $ Family Real Estate $

Your Work $ Pension/retirement $

Other members
$ Interest or dividends $
of household

Will there be any significant increases or decreases in your family’s income during the next year? Yes No
If yes, please explain: ___________________________________________________________________________________________

Does your family own its own home?

Yes No If yes, what are your monthly payments? $__________________

Does your family own a business?

Yes No If yes, please answer the below questions.
Date business commenced: ______________________ Your family’s share of business value: $__________________
Type of business: ______________________________ Your family’s share of business indebtedness: $__________________

How much money does your family owe to other people or to financial institutions? $_________________

Are there any restrictions on the exchange and relaease of funds in your country for study in the U.S.? Yes No
If yes, please explain: ___________________________________________________________________________________________
Do you have a source of emergency funds in the U.S.? Yes No
If yes, please name the source and amount available. _____________________________________________ $__________________

How will you pay for transportation to the U.S.?

 CERTIFICATION OF FINANCES
Sources of Funding: Indicate below, in U.S. dollars, the planned financial sources and amount you intent to use to cover yearly
educational expenses. Also enter the anticipated amount of support for each subsequent year.

Student’s Source of Funds First Year Second Year Third Year Fourth Year

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

$ $ $ $

Total $ $ $ $

Agencies/foundations/sponsor explanation: __________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

Required Supporting Documentation:

For all recorded funds listed above, please provide the following documentation below.

Student’s Source of Funds Required Documentation

If there are any unusual expenses, other debts or special circumstances Coe College should consider when making a decision on
available financial aid, please provide it here: __________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

_______________________________________________________________________________________________________________

We declare that the information on this form is true, accurate and complete. Coe College has our permission to verify the information
reported by obtaining documentation as needed. It is understood that providing false information may jeopardize a student’s visa status
and may result in refusing or canceling admission.

Student’s Signature ________________________________________________________________ Date ________________________

Father’s Signature _________________________________________________________________ Date ________________________

Mother’s Signature ________________________________________________________________ Date ________________________